This project, "Web-based Smoking Cessation Intervention: transition from inpatient to outpatient," addresses smoking among hospitalized patients, whose rates are higher than among the general population. Hospitalization offers a unique opportunity to intervene, as it requires temporary abstinence and patients are focused on health concerns. Hypotheses: A tailored web-based and e-message smoking cessation program for current smokers that upon hospital discharge, transitions the patient to continue a quit attempt when home (Transition2Quit) will be effective. Further, we hypothesize that this approach will be cost-effective. Specific Aims: 1. To test the effectiveness of a web-based smoking cessation intervention. 2. To determine the cost- effectiveness of this approach. Research Design - Methods: A randomized two-arm follow-up design will be used to test the effectiveness of an evidence- and theoretically-based smoking cessation program designed for post- hospitalization. Patients randomized to this arm will be contacted by hospital staff, trained as tobacco treatment transition specialists, to engage in TransitionZQuit, an interactive web-based program that offers personalized and tailored messages, e-group support, and text messages promoting tobacco abstinence. All hospitalized patients will receive standardized smoking cessation messages via DVD format that physicians can order (along with NRT and study referral) via the hospital's electronic order system. Our primary outcome is biologically confirmed tobacco abstinence at 12 months follow-up;we will also assess self-reported quit rates at 3 and 6 months and variables hypothesized to predict quit success. We will measure health care utilization and quality of life to allow testing the cost-effectiveness of this program conducted from the perspective of a hospital, health care payers, patients and society. Significance of results: At study completion we will know whether imbedding smoking cessation into usual hospital care, with minimal hospital-staff burden, and an interactive web-based tailored intervention program is an effective way to reduce smoking rates among hospitalized patients, and if it is cost-effective. This program will be an "off the shelf approach that could be disseminated easily. RELEVANCE (See instructions): This study aims to address the Health People 2010 objective 27-1 to reduce tobacco use by adults. Further it aims to extend knowledge about reducing tobacco use among a vulnerable group of people to enhance their health so that they can live longer and more fulfilling lives. This would result in a reduction of the burden of smoking on the health care system as well as society as a whole. (End of Abstract)